NUR155 / NUR 155 Final Exam (Latest 2025 / 2026 Update): Critical Thinking for the Practical Nurse | Questions and Verified Answers | 100% Correct (Grade A) – Hondros

NUR155 / NUR 155 Final Exam (Latest 2025 / 2026 Update): Critical Thinking for the Practical Nurse | Questions and Verified Answers | 100% Correct (Grade A) – Hondros . Question: Tanner's Model of Clinical Judgement Answer: A model based on how a nurse THINKS, it explains the 4 steps in the critical thinking process that nurses use to solve any problem: Noticing Interpereting Responding Reflecting Question: Nursing Process Answer: Uses the Scientific Method to complete a Step by step approach to PROVIDE PATIENT centered care: ADPIE Assessment Diagnosis -RN only Planning/Outcomes Implementation Evaluation Question: Why study Critical Thinking? Answer: Thinking with a purpose, know why you do what you do. Discipline specific reasoning process that ensures a nurse is generating, implementing, and evaluation approaches. Question: Benner's Theory of Stages of Clinical Competence Answer: 5 Stages of developing nursing clinical competence: Stage 1: Novice Stage 2: Advanced Beginner Stage 3: Competent Stage 4: Proficient Stage 5: Expert Credit to Question: Stage 1: Novice Answer: Nursing Student in first year of clinical education; limited and inflexible, rule based, limited ability to predict what might happen in a particular situation. Credit to Question: Stage 2: Advanced Beginner Answer: New grads in their first jobs, nurses have more experience and are able to recognize recurrent, meaningful components of a situation. They have the knowledge and the knowhow but not the in-depth experience. Credit to Question: Stage 5: Expert Answer: Nurses that are able to recognize demands and resources in situations and attain their goals. No longer do they rely solely on rules to guide actions under certain situations. They area able to intuitively grasp the situation based on their deep knowledge and experience. Credit to Question: Noticing Answer: First step of Tanner's model of clinical judgement. 1. Identifying signs and symptoms 2. Gathering complete and accurate data 3. Assessing systematically and comprehensively 4. Predicting and managing potential complications 5. Identifying assumptions Question: Noticing-1. Identifying signs and symptoms Answer: The ability to recognize that a situation is different, changed, and not of a normal state. Indcates that something is different than expected. Question: Noticing-2. Gathering complete and accurate data Answer: Collecting pertinent data from various sources. This data is used as the basis for identifying issues/concerns, solving problems, and making decisions. Must verify that data is complete and accurate. Question: Noticing-3. Assessing systematically and comprehensively Answer: An organized manner to collect data to make sure nothing is omitted or forgotten. Examining the whole, piece-by-piece in a thorough manner. Question: Noticing-4.Predicting and managing potential complications Answer: Looking at the big picture to consider possible complications for an individual patient. Must know common complications and consider individual differences. In Noticing, you are predicting complications, which means you are identifying possible problems. Question: Noticing-5. Identifying assumptions Answer: Taking something for granted or hastily arriving at a conclusion without supporting evidence. A misconception. Question: Nursing Process Assessment Answer: Observe and report to Charge Nurse or HCP. Determine risk for injury or infection. Question: Nursing Process Diagnosis Answer: Assist with accurate diagnosis. Gather data to confirm or eliminate problems. Specific causes of safety risk to an individual. Question: Nursing Process Planning/Outcomes Identifications Answer: Assist with setting priorities and goals, suggestions interventions. To prevent threats to safety. Question: Nursing Process Implementation Answer: Carry out planned interventions. Interventions, education, environment/development considerations. Question: Nursing Process Evaluation Answer: Assist with re-evaluation and make suggestions. Compare response/results to the original goals, plan of care. Question: Data Collection-Scope of Practice Answer: LPN's collect data, RN's complete Assessments. Question: Main Assessments Answer: 3 types: Focus Assessment Systemic Assessment Head to Toe Assessment Question: Focus Assessment Answer: Focusses on one body part. example: Heart, Lung, Stomach, etc... Question: Systemic Assessment Answer: Focusses on one body system. example: Respiratory, Digestive, Cardiac, etc... Question: Head to Toe Assessment Answer: Total body examination. Question: Parts of Clinical Thinking Answer: -Assess/learn/gain knowledge -Understand and ask questions -Store information/memorize -Recall information/bring it back -Know what to do when information isn't in memory (know where to look it up) -Draw your own conclusion Question: Humble Attitude Answer: We don't know everything. Question: 2 main types of data Answer: Objective vs Subjective Question: Objective Data Answer: (Signs) Observable and measurable data that can be seen and heard, or felt, smelled by someone other than you, or by physical examination and lab data. example: elevated temperature, vomiting, skin moisture... Question: Subjective Data (Answer: Symptoms) Information perceived only by the affected person, personal taste, symptoms, verbal statements provided by the patients point of view or perception. What the patient tells you. Question: Clinical Answer: Is related to/or conducted in a healthcare setting involving direct observation of the patient. Question: Judgement Answer: Your interpretation that influences your actions to take. Question: Clinical Judgement Answer: Interpretation or conclusion about a patient's needs, concerns, or health problems. Whether or not you should take action. Sometimes you have to improvise new actions or plans. Question: Why do we need Clinical Judgement? Answer: We need it to provide safe quality care. Question: How do we develop Clinical Judgement? Answer: We use the Nursing Process, and Tanner's Model to develop the skills to establish Clinical Judgement. Question: Emergency! Answer: Emergencies cease to exist when you prepare for them! Question: SPICES Answer: A tool that can be used to obtain information necessary to prevent health alterations in older adult patients. Question: SPICES-S Answer: Sleep Disorders Question: SPICES-P Answer: Problems with Eating or Feeding Question: SPICES-I Answer: Incontinence bowel and/or bladder Question: SPICES-C Answer: Confusion Question: SPICES-E Answer: Evidence of Falls Question: SPICES-S(2) Answer: Skin Breakdown Question: Epworth Sleepiness Scale Answer: Tool used to measure average daytime sleepiness. This information is used to determine if person is getting enough sleep. Scored 0-6: healthy 7-8 borderline 9-10 seek medical attention! (Most nursing students ;)) Question: Advanced Nursing Knowledge Answer: 6 Questions Critical Thinkers use. 1. What are you on alert for with this patient? 2. What are important assessments to make? -Focus -Systemic -Head to Toe 3. A. What complications may occur? B. What could go wrong? 4. What interventions will prevent complications? 5. How will you prioritize implementation of nursing interventions? Explain why? 6. What actions will you take for each complication, should it occur? Question: Maslow's Hierarchy of Needs Answer: 1. Physiological 2. Safety 3. Belonging 4. Self-Esteem 5. Self-actualization Question: 1. Physiological Answer: Breathing, sustenance, water, exertion, sex, sleep, homeostasis. Question: 2. Safety Answer: Body, home, employment, family, health, property. Question: 3. Belonging Answer: a feeling of having friends, family, and sexual intimacy. Question: 4. Self-esteem Answer: a feeling of self-esteem, confidence, achievement, respect. Question: 5. Self-actualization Answer: Realization of one's full potential. Question: Reflection IN action Answer: You are in the situation and you are thinking/processing as you go. Present tense. At the pts bedside Question: Reflection ON action Answer: Looking back, Past tense, reflecting on the situation after the fact. Debriefing on the situation. Documenting Question: Delegate When? Answer: Pt is stable task is within job description you're able to teach/supervise you've planned how to monitor Question: Don't delegate when Answer: thinking, complex assessment, and judgements required unpredictable outcome increased risk for harm creativity and problem solving is required Question: Delegation Answer: Transfer a duty. Your license is on the line Question: Delegation Steps Answer: Assess and plan Communicate Ensure supervision Evaluate and give feedback Question: Rights of Delegation Answer: right task- activity ok to be delegated? right circumstance or situation- appropriate supervision? right person- within scope of practice? right direction/communication- person understand the task being delegated? right supervision, teaching and evaluation- monitoring outcome? Question: Ex: Answer: How do you know food in the fridge is spoiled? Smell, taste, expiration date Identifying signs and symptoms Tanners- noticing Question: Ex: Answer: Chief complaint Identifying signs and symptoms Tanners- noticing Question: Ex: Answer: Patient interview Subjective and objective data Primary and secondary sources Gathering complete and accurate data Tanners- noticing Question: Ex: Answer: Head to toe Focused Body systems Assessing systematically and comprehensively Tanners- noticing Question: Ex: Answer: Recognizing that all surgical patients are at risk for pneumonia and atelectasis Predicting (and managing) potential complications Tanners- noticing Question: Ex: Answer: All elderly people are confused or can't hear well. Identifying assumptions Tanners- noticing Question: Ex: Answer: All things people are healthy Identifying assumptions Tanners-noticing Question: Ex: Answer: Two year old child not talking or hearing, mother Notices this isn't normal Identifying signs and symptoms Tanners-noticing Question: Ex: Answer: Thorough, correct, multiple sources, complete Gathering complete and accurate data Tanners-noticing Question: What's not right with a situation? Answer: Identifying signs and symptoms Question: primary source Answer: Patient Or Witnessed for hand (something you are present for) Question: secondary source Answer: Family Medical records Another nurse report during shift change Question: Interpreting Answer: 2nd step in Tanner's model of clinical judgement 1. Clustering related information 2. Recognizing inconsistencies 3. Checking accuracy and reliability 4. Distinguishing relevant from irrelevant 5. Determining the importance of information 6. Comparing and contrasting 7. (Predicting and) Managing potential complications 8. Judging how much ambiguity is acceptable 9. Using legal, ethical & professional guidelines Question: Interpreting 1- Clustering related information Answer: Grouping together information with a common theme. Organizing data to determine issues, problems, or concerns and better understand the issue Question: Interpreting 2- Recognizing inconsistencies Answer: Mismatched data , seeing if subjective and objective data support each other Question: Interpreting 3- Checking accuracy and reliability Answer: realizing something doesn't seem right; taking action to determine if it is accurate or not. Question: Interpreting 4- Distinguishing relevant from irrelevant Answer: Deciding which info is pertinent to that matter at hand. Associated with current condition Question: Interpreting 5- Determining the importance of information Answer: nurses must be able to sort through clinical noise, act on important information and disregard what is not important; you evaluate information to identify a possible new issue or problem that was not previously identified. (figure out what is new or what is changed.) Question: Interpreting 6- Comparing and Contrasting Answer: Looking at two similar cases, identifying the subtle differences, and acting on them. Question: Interpreting 7- (Predicting and) Managing potential complications Answer: Look at the big picture to consider possible complications Knowing common complications but considering individual differences. Question: Interpreting 8 Judging how much ambiguity is acceptable Answer: Nursing judgment based on acceptable normal ranges may vary depending on patient situation How much wiggle room? When is action needed? When pt becomes symptomatic Question: Using legal, ethical & professional guidelines Answer: (interpreting#9) nurses must consider legal, ethical, and professional guidelines when providing care. nurses must work within the legal guidelines of the nurse state practice act. Question: Ex: Answer: HIPAA violation Using legal, ethical & professional guidelines Tanners-interpreting Question: Ex: Answer: Pt has flu and a temp of 100.2 Temp is out of normal range but it's ok based on pt situation. I.e temp is your body's response to fighting infection Judging how much ambiguity is acceptable Tanners- Interpreting Question: Ex: Answer: Child bedtime is at 8pm. Tomorrow is a holiday and no school do you let child stay up until 9. Judging how much ambiguity is acceptable Tanners- interpreting Question: Ex: Answer: Encourage use of incentive spirometer or initiate an ambulation schedule to prevent pneumonia or atelectasis (collapsed lung) (Predicting and) Managing potential complications Question: Ex: Answer: Two pts have arthritis, what's different and what's the same Comparing and contrasting Tanners- Interpreting Question: Ex: Answer: Sorting laundry: whites, colors and delicates Clustering RELATED info Tanners- interpreting Question: Ex: Answer: Pt denies pain but grimaces Subjective and objective doesn't match Recognizing inconsistencies Tanners- interpreting Question: Ex: Answer: Child denies eating cake but had chocolate all on face Subjective doesn't match objective Recognizing inconsistencies Question: Responding Answer: 3rd step in Tanners model 1. Setting priorities 2. Delegating Question: Responding 1- setting priorities Answer: Comparing and sorting through info Ranking it in order of importance (Triage) Question: Responding 2- delegating Answer: Asking someone else to do part of your job. Must determine if person is willing and able to do the task Question: Ex: spill OJ on table with car keys, cell phone and hw... what do you pick up first? Answer: PRIORITY Setting priorities Tanners- responding Question: Reflecting Answer: 4th step in Tanners model 1. Evaluating data 2. Evaluating and correcting thinking Question: Reflecting 1- evaluating data Answer: After action/interventions performed.... data is collected again to determine if intervention was effective. Reflection - in - action. @ the pt bedside asking ?s Question: Reflecting 2- evaluating and correcting thinking Answer: Reflecting on what's happened, what was learned, how were the results. Reflection - on - action. Looking back, debriefing, documenting Question: Ex: Answer: Pt says pain is 8/10 Give pain meds Reassess in an hour. Did meds work? Reflection - in - action Evaluating data Tanners - reflection